Minimally Invasive Plate Osteosynthesis for Open Fractures of the Proximal Tibia

BACKGROUND: Relatively few studies have addressed plate osteosynthesis for open proximal tibial fractures by now. The purpose of this study was to assess the results of minimally invasive plate osteosynthesis (MIPO) for open fractures of the proximal tibia. METHODS: Thirty-four patients with an open proximal tibial fracture were treated by MIPO. Thirty of these, who followed for over 1 year, constituted the subject of this retrospective study. According to the AO Foundation and Orthopaedic Trauma Association (AO-OTA) classification, there were 3 patients of type 41-C, 6 of type 42-A, 8 of type 42-B, and 13 of type 42-C. In terms of the Gustilo and Anderson's open fracture grading system, 11 patients were of grade I, 6 were of grade II, and 13 were of grade III (III-A, 6; III-B, 6; III-C, 1). After thorough debridement and wound cleansing, when necessary, a soft tissue flap was placed. Primary MIPO (simultaneous plate fixation with soft tissue procedures) was performed in 18 patients, and staged MIPO (temporary external fixation followed by soft tissue procedures and subsequent conversion to plate fixation after soft tissue healing) was performed in 12 patients. Results were assessed according to the achievement and time to union, complications (including infections), and function of the knee joint using Knee Society scores. Statistical analysis was performed to identify factors influencing results. RESULTS: Primary union was achieved by 24 of the 30 study subjects. Early bone grafting was performed in 6 cases with a massive initial bone defect expected to result in non-union. No patient had malalignment greater than 10degrees. The mean Knee Society score was 88.7 at final follow-up visits, 23 patients achieved an excellent result, and 7 a good result. There were 3 superficial and 5 deep infections, but none required early implant removal. Functional results were similar for primary and staged MIPO (p = 0.113). Fracture pattern (p = 0.089) and open fracture grade (p = 0.079) were not found to influence the results. CONCLUSIONS: If soft tissue coverage is adequately performed, MIPO could be regarded as an acceptable method for the treatment of open proximal tibial fracture.

Metabolic Syndrome as a Predictor of Coronary Artery Calcification in Asymptomatic Korean Adults

INTRODUCTION: Identification of individuals at high risk for coronary heart disease (CHD) is a challenge, though essential, for the prevention of future events. Thus, early detection of CHD has been a priority in research and practice. We conducted a study to evaluate the relationship between metabolic syndrome (MS) and its components with coronary artery calcium (CAC) as a surrogate of CHD in a large Korean adult population. METHODS: The study subjects (n=14,429) were individuals who visited a health promotion center in Seoul, Korea from Jan. 2010 to Dec. 2010. Personal and family medical histories were collected and smoking status, anthropometric measurements, and laboratory tests were measured. CAC scores were measured by the multi-detector computed tomography. RESULTS: The study population consisted of 11,884 men (mean age 41.9+/-6.6 years) and 2,544 women (mean age 42.9+/-8.0 years). The total prevalence of MS was 19.6%, with 21% in men and 13.2% in women. CAC (CAC>0) was found in 15.0% of men and 5.4% of women. When compared to the non-MS group, the MS group had a higher prevalence of CAC after adjusting for age, smoking, and family history of stroke and CHD in both men (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.62-2.05; P<0.001) and women (OR, 2.23; 95% CI, 1.49-3.33; P<0.001). All individual components of MS, except high density lipoprotein cholesterol level, were associated with a high risk for CAC presence. CONCLUSIONS: Individuals with MS had a greater prevalence of CAC compared with individuals without this condition.

Metabolic Syndrome as a Predictor of Coronary Artery Calcification in Asymptomatic Korean Adults

INTRODUCTION: Identification of individuals at high risk for coronary heart disease (CHD) is a challenge, though essential, for the prevention of future events. Thus, early detection of CHD has been a priority in research and practice. We conducted a study to evaluate the relationship between metabolic syndrome (MS) and its components with coronary artery calcium (CAC) as a surrogate of CHD in a large Korean adult population. METHODS: The study subjects (n=14,429) were individuals who visited a health promotion center in Seoul, Korea from Jan. 2010 to Dec. 2010. Personal and family medical histories were collected and smoking status, anthropometric measurements, and laboratory tests were measured. CAC scores were measured by the multi-detector computed tomography. RESULTS: The study population consisted of 11,884 men (mean age 41.9+/-6.6 years) and 2,544 women (mean age 42.9+/-8.0 years). The total prevalence of MS was 19.6%, with 21% in men and 13.2% in women. CAC (CAC>0) was found in 15.0% of men and 5.4% of women. When compared to the non-MS group, the MS group had a higher prevalence of CAC after adjusting for age, smoking, and family history of stroke and CHD in both men (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.62-2.05; P<0.001) and women (OR, 2.23; 95% CI, 1.49-3.33; P<0.001). All individual components of MS, except high density lipoprotein cholesterol level, were associated with a high risk for CAC presence. CONCLUSIONS: Individuals with MS had a greater prevalence of CAC compared with individuals without this condition.

Reconstruction of the Glenoid Using Iliac Bone Graft for Recurrent Anterior Shoulder Instability with Severe Glenoid Bone Defect: A Report of Two Cases

PURPOSE: The purpose of this report was to assess a surgical technique-using an autogenous tricortical iliac crest bone graft in patients with epilepsy-for anatomical glenoid reconstruction for recurrent anterior glenohumeral instability with severe glenoid deficiency. MATERIALS AND METHODS: We studied two cases of recurrent anterior dislocation of the shoulder due to epilepsy. These cases were treated with anatomical glenoid reconstruction using an autogenous tricortical iliac crest bone graft. RESULTS: Both cases achieved bone union in 5 months. There was no recurrence of instability and pain. Both cases had normal range of motion. CONCLUSION: Anatomical glenoid reconstruction for recurrent anterior glenohumeral instability with severe glenoid deficiency using an autogenous tricortical iliac crest bone graft is a successful surgical technique for achieving shoulder stability.

Exposure to lonizing Radiation in the Emergency Department from Performed Portable Radiographs

To accurately assess the potential hazard of exposure to ionizing radiation from portable radiographs taken in the emergency department,.a study was performed to measure such radiation at different distances from the edge of an irradiated field during portable cervical spine, portable chest radiographs, and portable anteroposterior pelvis radiographs. For all three types of portable radiographs, radiation exposure is high at the edge from the beam. However, radiation exposure is deceased at 20, 40, 80, 160cm away from the beam. This study confirms and supports the evidence that although radiation exposure is dependent on distance from the primary radiograph beam, exposure in the ED is minimal. Medical personnel should not have to leave a patient care area for fear of undue acute and chronic radiation exposure while portable radiographs are performed in the ED. By using protective garments and standing appropriate distance away from the patient, continuous patient care can be maintained while portable radiographs are taken in the ED.

The Analysis of Motorcycle Accident

In Korea, there are about 8 million motor vehicles and one-fourth of it is motorcycle. Last year Korean government report on the motor vehicle accidents claimed 12,781 cases of motorcycle accidents and it account for 5.1% of all of motor vehicle accidents occurred in Korea. But this is too broad analysis and lack of statical values. In general, most of people think motorcycle rider will suffer or die from head injuries sustained with motorcycle accident. Even though mandatory law on wearing helmet during motorcycle ride, but we see too many motorcycle riders not wearing helmet, especially in teenagers. The loss of young person by accident is great loss for family, society and economy of nation. No one will doubt the effectiveness of helmet on reduced incidence of head injuries. And multiple studies from United States of America have clearly demonstrated the benefit of helmets in motorcycle accidents. The following study was undertaken to determine the relationship between head injuries and helmet use in motorcycle accident, as well as analysis of general motorcycle accident.